Care Coordination is On Many Providers' Christmas Wish Lists

Posted by Cam McClellan Teems

December 23, 2016 at 12:09 PM



Across the health care industry, many providers, policymakers and IT organizations primarily focus on the “Triple Aim” of improving patient care along with the overall health of populations while simultaneously reducing the per capita cost. Yet there has been little fanfare about the provider experience. A recent article from Healthcare IT News examines how many providers are turning to a “Quadruple Aim” that also incorporates provider considerations by implementing electronic consultation and referral (eCR) systems to improve care coordination and, in turn, provide a better experience for both patients and providers. 

Many leaders in healthcare are saying that improving the provider experience is more necessary than ever with the increased focus on value-based care. Because a provider's professional reimbursement is at risk in a value-based world, they are becoming more vested in patients’ care coordination (or lack thereof). Providers often feel anxious and out-of-the-loop in what is happening to patients when they receive care from other providers and in other settings. This lack of visibility into coordination of care can result in patient over-utilization and keep providers from accessing top-tier reimbursement, or even worse, penalize them.

One way to improve patient coordination as well as to gain better insight into care quality is by implementing eCR technology. Many specialty IT systems or applications allow providers to review patients' intake (referral, history of present illness, initial case data, etc.) information to determine efficacy of referrals and how to maximize a patient's clinical pathway experience based on how they are initially presenting or through applied analytic algorithms that give deeper insight to personalize treatment. This maximizes the provider’s available time and increases patient satisfaction by keeping them from unnecessarily bouncing between appointments and providers.

Delphine Tuot, director of the Center for Innovation in Access and Quality (CIAQ) at the University of California, San Francisco, assists providers with planning and implementing eCR systems. In 2005, the CIAQ led planning and implementation for what is now one of the most robust eCR systems in the country, which focused on San Francisco’s “safety net” population of patients who were either enrolled in public insurance programs or were uninsured. “A multitude of studies have shown that care coordination across the referral process is suboptimal, and that the flow of information from primary care to specialty care and back is suboptimal,” Tuot said.

Addressing these suboptimal processes will have positive downstream effects in outcomes, adherence to value-based managed care bundles and risk-based contracts, and patient satisfaction, and helping providers feel more in control of the patient experience. In addition, oversight of the patient pathway brings peace of mind for providers and helps break down barriers to treatment. Proper care coordination benefits all aspects of health care, and applying new technology to navigate the demands of population health issues is the next step in not only improving patient outcomes, but also in ensuring that providers are able to provide the best care possible.

Topics: Navigation & Care Coordination, Barriers to Care, Value-Based Care, Healthcare Providers

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